Stricker P D, Grant A B, Hosken B M, Taylor J S
Department of Urology, Royal Newcastle Hospital, New South Wales, Australia.
J Urol. 1990 Jan;143(1):34-5; discussion 35-6. doi: 10.1016/s0022-5347(17)39855-5.
We studied 15 patients with histologically proved multifocal carcinoma in situ of the bladder who were in remission at a mean followup of 21 months after induction intravesical chemotherapy with mitomycin C. These patients have been followed for a further 28 months, for a total mean duration of 49 months. Of the 15 patients 4 suffered new areas of carcinoma in situ, including 3 who subsequently required cystectomy (2 after unsuccessful intravesical bacillus Calmette-Guerin therapy and 1 with a simultaneous invasive tumor). One patient underwent transurethral resection of the prostate for carcinoma in situ of the prostatic urethra, which subsequently was shown to be limited to mucosa and not involving the deeper ducts nor the stroma. Of the remaining 11 patients 1 died of unrelated disease and 2 suffered recurrent papillary transitional cell carcinoma treated successfully with a combination of intravesical bacillus Calmette-Guerin therapy and resection. The other 8 patients have remained free of tumor. None of the 15 patients had metastatic cancer. We believe that these results support the durability of response after induction mitomycin C therapy. We stress the necessity for prolonged close followup to detect recurrent tumor and to avoid metastatic disease.
我们研究了15例经组织学证实为膀胱多灶原位癌的患者，这些患者在接受丝裂霉素C膀胱内诱导化疗后平均随访21个月时处于缓解期。这些患者又被随访了28个月，总平均随访时间为49个月。15例患者中有4例出现了新的原位癌区域，其中3例随后需要进行膀胱切除术（2例在卡介苗膀胱内治疗失败后，1例同时伴有浸润性肿瘤）。1例患者因前列腺尿道原位癌接受了经尿道前列腺切除术，随后显示病变局限于黏膜，未累及更深的导管和基质。其余11例患者中，1例死于无关疾病，2例患有复发性乳头状移行细胞癌，通过卡介苗膀胱内治疗和切除术联合成功治疗。其他8例患者无肿瘤复发。15例患者均无转移性癌症。我们认为这些结果支持了丝裂霉素C诱导治疗后反应的持久性。我们强调需要长期密切随访以检测复发性肿瘤并避免发生转移性疾病。
